1a: The Winter Fuel Payment (WFP) is a UK policy intervention aimed at improving older adults’ health and well-being by reducing their exposure to cold indoor temperatures. This research will examine whether WFP recipients aged ≥60 years experience better cardiovascular, respiratory, and inflammation-related health outcomes and perceptions of physical and mental well-being than similarly aged individuals in non-recipient households. As the WFP particularly seeks to attenuate health effects of fuel poverty, this research will investigate whether low income individuals experience greater benefits.

1b: Cold indoor temperatures are hypothesized contributors to excess morbidity and mortality observed during winters, but benefits of potential interventions remain largely unknown. Older persons are particularly vulnerable to fuel poverty and even mild cold stress, with cardiovascular, respiratory, and mental health problems most strongly associated with low indoor temperatures. By focusing on objective physiologic mechanisms and self-reported symptoms related to these health outcomes, and on an existing UK-wide policy, this research will inform decisions regarding policy-levers to improve vulnerable households’ health and meet UK Biobank’s “aim of improving the prevention…of serious and life-threatening illnesses.”

1c: The WFP extends an annual cash payment to households with the oldest member aged ≥60 years as of each year’s qualifying week. Qualifying weeks are administratively chosen and can be considered ‘random’: households whose eldest member turned 60 right before (recipient) versus right after (non-recipient) WFP-qualifying weeks are expected to be similar with respect to other factors, observable and unobservable, that influence health and well-being. The statistical technique Regression Discontinuity will be used to test for ‘jumps’ in health outcomes between households just above and just below the WFP eligibility cut-point, mimicking a natural experiment.

1d: Full cohort data are requested. The primary research population will include participants aged 50-70 years and in private homes, but WFP-related health benefits among younger individuals living with older WFP recipients/non-recipients are also of research interest. Further analyses will examine participants from narrower age bands (e.g., 58-61 years), single-persons or other groupings for which household WFP status can be accurately inferred (to reduce exposure misclassification of participants not personally WFP eligible but living in WFP-receiving households), and winter data collection visits (since acute WFP effects are hypothesized strongest in colder months).